Individual
MRS. KHIMBERLY ROSE SCHOENACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSP, LD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-5257
(503) 418-5317
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 418-5257
(503) 418-5317
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
957173
ADA REGISTRATION NUMBER
CA
Enumeration date
05/16/2007
Last updated
10/13/2010
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